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October 5, 2025Jurnal Rekam Medis dan Informasi Kesehatan Indonesia.Open Access

Factors Causing Pending Claims on Health BPJS Patients with Fishbone Diagrams at Al–Hikmah Clinic Sukorejo Ponorogo Districrt

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Authors

HIHindun Al IstiqomahDNDwi Nurjayanti

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Overview

Qualitative analysis shows factors causing pending claims in BPJS Health payments at a clinic, highlighting system and documentation issues.

Key Points

  • Pending claims arise from disputes between BPJS Health and health facilities over medical coding.
  • Key factors include incomplete claim documents and errors in the P-Care application, affecting claim processing.
  • Interviews and observations were employed to analyze the factors affecting BPJS Health claims at the clinic.
  • Recommendations call for improved training and system upgrades to reduce pending claims and enhance efficiency.

Cite This Study

Istiqomah et al. (2025) studied this question.

synapsesocial.com/papers/68e22da774308421369af00ehttps://doi.org/10.62951/jurmiki.v4i2.100
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Factors Causing Delays in BPJS Health Inpatient Claims at Dr. Harjono S Regional General Hospital in Ponorogo Regency2025 · 3 citations
  2. 2Analysis of Factors Causing Pending Claims for Inpatient JKN Patients Using the Fishbone Diagram Method Approach at Hospital X2025
  3. 3Factors contributing to delayed health insurance outpatient claims and administrative optimization strategies2025
  4. 4Analysis Of The Causes Of Pending Bpjs Health Claims At Melania Bogor Hospital2025
  5. 5AN INTEGRATED FRAMEWORK FOR HEALTH CLAIM CLASSIFICATION AND HOSPITAL FINANCIAL VIABILITY.2025